Abscess – Acute or chronic, localized inflammation, with a collection of pus.
Abutment – A tooth or implant used to support a dental prosthesis.
Alveolar – Referring to the bone to which a tooth is attached.
Alveoloplasty – A surgical procedure for recontouring alveolar structures, usually in preparation for a prosthesis.
Amalgam – A mixture of metals used in dental restorations (commonly referred to as a silver filling).
Analgesia – Loss of pain sensation without loss of consciousness.
Anesthesia – Partial or total absence of sensation to stimuli. There are three types of anesthesia:
General Anesthesia – A controlled state of unconsciousness, accompanied by a loss of ability to independently maintain airway and respond purposefully to physical stimulation or verbal command.
Intravenous Conscious Sedation – A depressed level of consciousness that retains the patient’s ability to independently and continuously maintain an airway and to respond appropriately to physical stimulation or verbal accompanied by a loss of ability to independently maintain airway and respond purposefully to physical stimulation or command.
Local Anesthesia – Elimination of sensations, especially pain, in one part of the body by the topical application or regional injection of an anesthetic drug.
Anniversary Date – The day and month that the patients’ insurance first became effective, and on which coverage renews.
Anterior – Refers to the teeth and tissues located in the front of the mouth – upper and lower incisors and canines.
Apex – The tip or end of the root of a tooth.
Apicoectomy – Removal (amputation) of the apex of a tooth.
Arch – The curved structure of the natural dentition or the ridge remaining after the loss of some or all of the natural teeth.
Assignment Of Benefits – A clause in the policy that allows the insured person to direct the payment by the carrier to the dentist. The insured person does this by signing the assignment box on the claim form, or by signing a “signature on file” form.
Back Teeth – See Posterior Teeth
Benefit Year – Usually begins on the month of the year that the employer purchased the plan.
Benign – The mild character of an illness or non-malignant character of a neoplasm.
Bicuspid – A tooth with two cusps, usually in front of a molar and referred to as a premolar.
Bilateral – Pertaining to both sides of the mouth.
Biopsy – Process of removing tissue for laboratory evaluation.
Birthday Rule – When a child is covered under both parent’s plans, the plan of the parent who’s birthday (month and day, not year) falls earlier in the calendar year is billed first.
Bitewing – An X-ray that shows the upper and lower teeth’s biting surfaces on the same film. This x-ray shows the portion of the teeth above the gumline.
Bonding – The process by which two or more components are made into one by mechanical and/or chemical adhesion at their interface.
Bridge – There are two types of bridges:
Fixed Bridge – A prosthetic replacement of one or more missing teeth cemented or attached to the abutment teeth or implants adjacent to the space.
Removable Bridge – A prosthetic replacement of one or more missing teeth on a framework that can be removed by the patient.
Bruxism – Grinding of teeth.
Buccal – Facing the cheek.
Calendar Year – January 1st to December 31st.
Calculus – Hard deposits of mineralized plaque which are attached to the crowns and or roots of teeth; also referred to as tartar.
Canal – The narrow chamber inside the root of the tooth that contains the nerve and blood vessels.
Canines – See cuspids.
Capitation Plan – A plan where the dentist is contracted with the administrator to provide dental services to persons covered under the program in return for payment on a per-capita basis (per head).
Caries – Commonly used term for tooth decay.
Carrier – The party (usually an insurance company) that pays the claims and collects the premiums.
Carryover – If the deductible was paid during the last 3 months of the prior year, it can carry forward into the current year and not be paid again.
Cementum – Hard connective tissue covering the root portion of a tooth.
Cleaning – See prophylaxis.
Cleft palate – A congenital deformity resulting in lack of fusion of the soft and or hard palate, may be either partial or complete.
Clenching – The clamping and pressing of the jaws and teeth together, frequently associated with psychological stress or physical effort.
Closed Panel – A plan where the covered patient only receives benefits if the services are provided by a dentist who is under contract with the dental benefit company or plan.
C.O.B. – See Coordination Of Benefits.
Complete Series – See Full Mouth X-rays.
Composite – A dental restorative material made up of separate parts (e.g. resin and quartz particles).
Coordination Of Benefits (C.O.B.) – This process becomes involved when the patient is covered by more than one plan. Coverage is then divided between the two plans using guidelines established by the National Association of Insurance Commissioners.
Coronal – Refers to the crown of a tooth.
Crown – There are three types of crowns:
Anatomical Crown – That portion of the tooth normally visible and covered by enamel.
Artificial Crown – A restoration covering or replacing the major part of the anatomical crown.
Abutment Crown – An artificial crown serving for the retention or support of a dental prosthesis.
Crown Lengthening – A surgical procedure exposing more of the tooth for restorative purposes by repositioning the gingival margin and/or removing supporting bone.
Curettage – Scraping or cleaning the walls of a cavity or gingival pocket.
Cusp – A pointed or rounded eminence on or near the chewing surface of a tooth.
Cuspids – The third tooth from the center of the mouth to the back of the mouth. These are the front teeth that have one rounded or pointed edge used for biting. Also known as canines.
Cyst – A pathological cavity or space, containing fluid or soft matter.
Debridement – Removal of subgingival and/or supragingival plaque and calculus which obstructs the ability to perform an evaluation; removal of bruised and devitalized tissue from a wound surface.
Decay – The lay term for carious lesions in tooth; decomposition of tooth structure.
Deciduous – To fall off or shed; a name used for the primary (baby) teeth.
Deductible – The amount paid by the patient before the carrier starts to pay benefits.
Dental Health Maintenance Organization (DHMO) – A legal entity that accepts the responsibility of providing services at a fixed price. The enrollees in these plans must have dental care provided through designated doctors.
Dentin – That part of the tooth that is beneath enamel and cementum.
Dentition – The teeth in the dental arch.
Denture – An artificial substitute for natural teeth and adjacent tissues.
Dependent – Usually the spouse and children of the subscriber.
Diagnostic – Procedures performed by the dentist to evaluate the condition of the teeth and mouth.
Diastema – A space, such as one between two adjacent teeth.
Distal – Toward the back of a tooth or the dental arch (away from the midline).
D.H.M.O. – See Dental Health Maintenance Organization.
Dry Socket – Localized inflammation of the tooth socket, following an extraction, due to infection or loss of blood clot.
Edentulous – Without teeth.
Eligibility – A process used to determine if the patient is eligible for benefits. This should be done before the treatment begins.
Enamel – Hard calcified tissue covering the dentin on the crown of a tooth.
Endo – See Endodontics.
Endodontic – Relating to the pulp.
Endodontist – A dental specialist whose practice is limited to treating disease and injury to the pulp. Endodontists perform root canal therapy and other services related to the blood vessels and nerve tissue inside teeth.
Equilibration – Reshaping of the occlusal surfaces of teeth to create proper contact between the upper and lower teeth; also know as occlusal adjustment.
Excision – Surgical removal of bone and/or tissue.
Exclusion – A service not covered by a dental policy.
Exostosis – Overgrowth of bone.
Facial – The surface of a tooth directed toward the face (including the buccal and labial surfaces).
Fee Schedule – A set amount paid by the insurance company that is unrelated to the doctor’s fee.
Filling – A term used for the restoration of lost tooth structure with materials such as amalgams or plastic.
Fluoride – A gel or liquid that prevents decay.
F.M.X. – See Full Mouth X-rays.
Foramen – A natural opening into or through bone.
Front Teeth – See Anterior Teeth.
Full Mouth X-RAYS (F.M.X.) – X-rays showing all the teeth. Includes 14 periapicals and 2 or 4 bitewings. Also known as a complete series.
Gender Rule – When a child is covered under both parent’s plans, the father’s plan is billed first.
General Anesthesia – Medication that relieves the sensation of pain on the whole body. General anesthesia renders you unconscious.
Gingiva – The soft tissue surrounding and supporting the teeth; otherwise know as the “gums”.
Gingivectomy – The removal of gingival tissue.
Gingivitis – Inflammation of gingival tissue.
Gingivoplasty – Surgical procedure to reshape gingiva to create a normal, functional shape.
Graft – A piece of tissue or material placed in contact with tissue to repair a defect.
Hemisection – Surgical separation of a multirooted tooth so that one root and/or the overlaying portion of the crown can be surgically removed.
Immediate Denture – A denture constructed for placement immediately after removal of all remaining teeth.
Impacted – An unerupted or partially erupted tooth that is positioned against another tooth, bone or soft tissue so that complete eruption is unlikely.
Implant – A device specially designed to be placed surgically within or on the jaw bone as a means of replacing teeth.
Incentive Program – A dental plan where benefits start at a given percentage and the percentage increases each year if the patient visits the dentist annually for preventive treatment. However, if the patient fails to go to the dentist each year the percentage drops back to where it started.
Incisors – The central and lateral incisors, are the first and second teeth from the center of the mouth to the back of the mouth. These are the front teeth with flat edges for biting.
Inlay – A laboratory processed restoration made of metal, acrylic or porcelain. This filling does not involve the high points of the tooth (cusps).
Interproximal – Between the adjoining surfaces of adjacent teeth.
Jaw – A common name for either the maxilla or the mandible.
Labial – Pertaining to or around the lip.
Least Cost Alternative – A clause in the policy that allows an insurance company to pay for the least expensive treatment.
Lesion – An injury or wound; area of diseased tissue.
Lingual – Pertaining to or around the tongue.
Local Anesthesia – Medication that relieves the sensation of pain in a localized area.
Malar – Pertaining to the cheek bone.
Malignant – Having the abnormal properties of dysplasia, invasion and metastasis.
Malocclusion – Improper alignment of biting or chewing surfaces of the upper and lower teeth.
Managed Care Plans – Plans that restrict the type, level and frequency of treatment; limit the access to care; and control the level of reimbursement for services. These are D.H.M.O.’s, Capitation plans, Closed Panel plans, PPO plans or other network based programs.
Mandible – Lower jaw.
Maxilla – Upper jaw.
Maximum – The maximum dollar amount of benefits a plan will pay toward the cost of dental care over a specific period of time (usually one year).
Mesial – Toward the front of a tooth or the dental arch (towards the midline).
Molar – A posterior tooth used for grinding; behind the premolars (bicuspids) on either side of the jaw, having a large crown and a broad chewing surface.
Mucous Membrane – The lining of the oral cavity; also called mucosa.
Nightguard – A removable acrylic appliance to minimize the effects of grinding (bruxism) or joint problems (T.M.J.). Usually worn at night to prevent grinding or relieve joint pain. Also known as an occlusal guard.
Obturator – A prosthesis that closes an opening in the palate.
Occlusion – Any contact between biting or chewing surfaces of the upper and lower teeth.
Onlay – A laboratory processed restoration made of metal, porcelain or acrylic that replaces one or more of the highest points of the tooth (cusps).
Operculectomy – Removal of the operculum.
Operculum – The flap of tissue over an unerupted or partially erupted tooth.
Oral – Pertaining to the mouth.
Oral Surgeon – A dental specialist whose practice is limited to diagnosing and treating diseases, injuries, deformities and defects of the mouth.
Orthodontist – A dental specialist whose practice is limited to preventing and treating malocclusion of the teeth.
Orthognathic – The functional relationship between the maxilla and the mandible.
Overdenture – A prosthetic device that is supported by retained roots or implants.
Palate – The hard and soft tissues forming the roof of the mouth that separates the oral and nasal cavities.
Palliative – Treatment that temporarily relieves pain but is not curative.
Panorex – An x-ray taken outside of the mouth that shows all the teeth on one film.
Partial Denture – A prosthetic device that replaces the missing teeth with a framework that can be removed by the patient.
Pediatric Dentist – A dental specialist whose practice is limited to treating children; formerly known as a pedodontist.
Pedo – See Pedodontics.
Pedontics (PEDO) – The treatment of children’s teeth.
Periapical – The area surrounding the end of the tooth root.
Pericoronal – Around the crown of a tooth.
Perio – See Periodontics.
Perio Charting – Measures the depth that the gums have detached from the side of the tooth.
Periodontal – Pertaining to the supporting and surrounding tissues of the teeth.
Periodontal Maintenance – Cleaning of the teeth following periodontal treatment, includes perio charting.
Periodontics (PERIO) – The treatment of diseases of the gum or bone (supporting structures).
Periodontist – A dental specialist whose practice is limited to the treatment of diseases of the supporting and surrounding tissues of the teeth.
Periodontitis – Inflammation and loss of the connective tissue of the supporting or surrounding structures of teeth.
Perio Pocket – The pocket that forms when the gums detach from the side of the tooth.
Perio Prophy – See Periodontal Maintenance.
Perio Recall – See Periodontal Maintenance.
Permanent First and Second Molars – The adult first and second molars, are the sixth and seventh teeth from the center of the mouth to the back of the mouth.
Permanent Molars – The adult first, second and third molars.
Permanent Dentition – See Permanent Teeth.
Permanent Teeth – The adult teeth. Also known as the permanent dentition.
Plaque – A soft sticky substance that accumulates on teeth composed largely of bacteria.
Pontic – The term used for the artificial tooth on a fixed bridge.
Post – An elongated metallic projection cemented within the prepared root canal, serving to strengthen and retain restorative material and/or a crown restoration.
Posterior – Refers to teeth and tissues toward the back of the mouth, (premolars, bicuspids and molars).
P.P.O. – See Preferred Provider Organization.
Preauthorization – See Predetermination.
Precert – See Predetermination.
Precertification – See Predetermination.
Precision Attachment – An interlocking device integrated into a fixed or removable prosthesis to help keep the prosthesis in place.
Pre D – See Predetermination.
Predetermination – A process used to determine the benefits available for dental services that are planned by the dentist: an estimate of the amounts payable by the plan if services are rendered when the patient is eligible.
Pre-Existing Condition – When benefits are allowed to treat a condition that was present when the patient first became insured.
Preferred Provider Organization (P.P.O.) – A network of dentists who have agreed to accept discounted fees for patients covered by a specific dental program.
Preventive – A procedure performed to prevent decay and gum disease. The procedures that are classified as preventive include prophylaxes, fluoride treatment and the placement of sealants.
Primary Dentition See Primary Teeth.
Primary Plan When the patient is insured by two plans, the plan that is billed first is the primary plan. The order is determined by guidelines established by the National Association of Insurance Commissioners.
Primary Teeth The baby teeth. Also known as the primary dentition or first set of teeth to erupt.
Prophy – See Prophylaxis.
Prophylaxis – A polishing procedure performed to remove coronal plaque, calculus and stains; often referred to as a cleaning.
Prosthesis – An artificial replacement of any part of the body; dental prosthesis is any device or appliance replacing one or more missing teeth.
Prosthetic – A fixed or removable appliance to replace missing teeth, such as a bridge, partial denture or full denture.
Prosthetic Replacement – The replacement of an existing bridge, partial or full denture.
Prosthodontics – Dealing with the replacement of missing teeth with prosthetic devices.
Prosthodontist – A dental specialist whose practice is limited to the restoration of the natural teeth and/or the replacement of missing teeth.
Provider – The dentist who renders treatment to the patient.
Provisional – A temporary or interim solution.
Pulp – The blood vessels and nerve tissue that occupies the pulp cavity of a tooth.
Pulp Cavity – The space within a tooth, which contains the pulp.
Pulpitis – Inflammation of the dental pulp.
Pulpotomy – Removal of a portion of the pulp.
Quadrant – One of the four equal sections into which the dental arches can be divided; begins at the midline of the arch and extends back to the last tooth (right and left sides of both arches).
Radiograph – X-ray.
R.C.T. – See Root Canal Therapy.
Reline – Process of resurfacing the tissue side of a denture with new material.
Resin Filling – See Composite Filling.
Restorative – Procedures performed to restore missing or decayed teeth.
Retainer – Appliance to stabilize the teeth following orthodontic treatment.
Retrograde Filling – A method of sealing the root canal by filling it from the root apex.
Root – The anatomic portion of the tooth that is covered by cementum and is located in the socket of bone.
Root Canal – The chamber within the root of the tooth that contains the pulp.
Root Canal Therapy – Treating disease of and injuries to the pulp usually by removing the pulp from the canal of the tooth and replacing it with a filling material.
Root Planing – A procedure designed to remove calculus from the root surfaces of teeth.
Scaling – The removal of plaque, calculus and stain from teeth.
Sealant – A clear application of acrylic placed over the biting surface of the tooth to prevent decay.
Secondary Plan – When a patient is insured by two plans, the plan that is billed second is the secondary plan. The order is detemined by guidelines established by the National Association of Insurance Commissioners.
Sialodochoplasty – A surgical procedure for the repair of a defect and/or restoration of a portion of a salivary gland duct.
Sialolithotomy – A surgical procedure by which a stone within a salivary gland or its duct is removed.
Signature on File – When the patient signs a statement in the dental office, but does not sign the actual claim form being submitted. The statement in question may authorize the dentist to receive information about the patient, or may assign benefits to the dentist.
Single Film – See Periapical.
Splint – A device used to support, protect, or immobilize oral structures that have been loosened, replanted, fractured or traumatized.
Stomatitis – Inflammation of the membranes of the mouth.
Subscriber – The person who carries the dental plan.
Suture – A stitch used to repair an incision or wound.
TARTAR – See Calculus.
TMJ – Temporomandibular joint – the hinge between the lower jaw (mandible) and base of the skull (temporal bone).
Temporomandibular Joint Disfunction – Abnormal TMJ functioning also refers to symptoms arising in other areas secondary to the disfunction.
Third Molar – See Wisdom Tooth.
Torus – A bony elevation or outgrowth of bone.
Trismus – Limited ability to open the mouth, usually due to inflammation.
U.C.R. – See Usual, Customary and Reasonable.
Unerupted – Tooth or teeth that have not penetrated into the mouth.
Uniclaim – A universal claim form that can be used instead of waiting for the patient to bring in their form. Some insurance companies may not accept uniclaims.
Unilateral – One-sided.
Usual, Customary and Reasonable (U.C.R.) – The dentists fee that is usually charged, customary in a given area, and reasonable because of special circumstances (difficulty).
Veneer – A layer of tooth colored material attached to the surface.
Virgin Teeth – Teeth that have no decay or fillings.
Waiver of Deductible – When the deductible does not apply to certain procedures (usually diagnostic & preventive).
Wax-Up – A wax form that is a model of an object to be fabricated.
Wisdom Tooth – The third molar, or eighth tooth from the center of mouth to the back of the mouth. Wisdom teeth are often impacted (obstructed from erupting) and have to be extracted.
X-ray – Radiograph.
Xerostomia – Decreased salivary secretion that produces a dry and sometimes burning sensation of the mouth.
Zygomatic Bone – Quadrangular bone on either side of face that forms the cheek prominence.